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Risk-taking near the End of Life by Monica Williams-Murphy, MD

Dr. Monica Williams-Murphy is a Board Certified Emergency Medicine Physician, who practices in one of the largest emergency departments in the United States at Huntsville Hospital. Through her writing and speaking, she is devoted to transforming the end of life into a time of peace, closure and healing. Media Page

Me and my Dad

I am basically a risk-taker. I think this is to some extent genetic; it’s in my blood. My very own father is a risk-taker– he spent most of his life driving high speeds for fun- he was first an amateur then a professional race car driver as I was growing up. At one point in my childhood, he quit his job in the coal mines to strike out on his own, to start his own business—to leave the safe and known world to enter the risky and unknown.

So, it came as no surprise to me when my now late-stage-COPD-home- oxygen-wearing-father called me up and said, “I’m leaving to drive to a high altitude area in New Mexico tomorrow to see some friends.” (Mind you, we live near sea level in Alabama and he gets short of breath just walking to the restroom.)

Without missing a beat, I said, “Well, OK.” The rest of the conversation was working out the details of how to do this. There was no hesitation, no pause. It was a moment of pure understanding between us- one risk-taker to another.

My sisters thought that we were both crazy- him for going and me for saying this was a fine idea. Most people would suggest that they were functioning from a more rational perspective than we were. I’m OK with that opinion, but I also want to give a plug for risk-taking near the end of life…for those of us who are more willing to live on the edge.

I have long begrudged the fear that often accompanies the frailty which develops near the end of life. I have seen fearless people become wimps, and I hate when this happens. In the years before my own mother-in-law’s death, she was transformed from a fearless-world-traveling-avenger-of-wrongs to a fearful-walker-clutching-kyphotic-elder. This bothered me. I wanted her to leave this world with the same sound and fury with which she roamed the earth for 80+ years.

So, in my father’s case, I was more than happy to see him off on his very risky journey. It felt like a triumph for us both- he was off on a grand adventure and I was happy for him… glad to see him go…to act in the face of his own fears. He was brave. This could very well have been his last trip…ever.

After he arrived back home from what proved to be a very arduous journey, I told him that in the days he was gone, I searched my heart about our decision to let him make this trip.

In my head, I had the same conversation that I have with my “end-stage” patients in the ER : “What is it you want to do with the time you have left? Do it now.”

And then, I told Dad that asked myself the “elephant in the room” question: “What if you died while in New Mexico? What if the journey itself killed you?”

The response, from my heart, was: “Then you would have died the way you lived-taking risks- but most importantly, you would have died doing what you wanted to do. What a way to go…”

"It's OK to Die" is a ground-breaking book filled with graphic stories straight out of the Emergency Room illustrating how most Americans are completely unprepared for death and dying. In response, the authors have created a unique and comprehensive guide urging EVERYONE to prepare in advance, to assure their own peace and to prevent the suffering of their loved ones. Learn More..

What a wonderful story! I am reminded of Dr. Alan Teel’s book “Alone and Invisible No More” in which he talks about risk-aversion playing too large a role in elder support programs. When and if we ask our patients “how bad would it be if you died taking that trip (staying at home, sky diving, etc.”) they often say, “Great! What a way to go!” An 85 year old uncle of ours recently died while hiking and everyone agreed it was a blessing. He was thriving to the very end. When we can talk frankly about dying we discover what makes life meaningful.
Kate Schwarz

“Do not go gentle into that good night…Rage, rage against the dying of the light.” [Dylan Thomas] This article reminds me of that poem.

I do love it – the article is an absolutely first-rate, beautiful illustration of dying well. Do what you know and love to do. If it kills you, if you die doing it, that will be a good death. Yes, it’s risky to keep going when the going might kill you. But the alternative is to begin dying long before it actually happens – to pull back with fear and wait for death. That is an even greater risk! What a waste of life – possibly the best days of life!! In your own words, “What human would rob another of the most touching and beautiful moments of life?….Death…allows us to cherish both life and time more fully.” [From your 19 Dec. 2012 article, “The value of ‘deadlines’ and a reflection on the new year] You and dad had it the right way: live while you still can. Live fully till the end. Take the risk that the end will come a little sooner…but it will be happier…for everyone! Now, that’s a plan!

Dying teaches us to push through fear and reach for life. It teaches us to honor the journey of others and refine unconditional love with many heart stopping, fear in throat moments; punctuated with the realization that this is how it should have been done all along. That we allowed humans and logic and doctors and institutions to tell us to be or do things differently when our hearts and souls cried out for more.

The most useful years of my life on this earth have been spent transitioning end of life people in the way that THEY want and honoring their paths and their hearts.

Keep writing …you are a glorious and wonderful human being who is here to teach many what life and love are all about.

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